Abstract
Remote presence in an operating room to allow an experienced surgeon to proctor a surgeon has been promised through robotics and telesurgery solutions. Although several such systems have been developed and commercialized, little progress has been made using telesurgery for anything more than live demonstrations of surgery. This pilot project explored the use of a new videoconferencing capability to determine if it offers advantages over existing systems. The video conferencing system used is a PC-based system with a flat screen monitor and an attached camera that is then mounted on a remotely controlled platform. This device is controlled from a remotely placed PC-based videoconferencing system computer outfitted with a joystick. Using the public Internet and a wireless router at the client site, a surgeon at the control station can manipulate the videoconferencing system. Controls include navigating the unit around the room and moving the flat screen/camera portion like a head looking up/down and righttleft. This system (InTouch Medical, Santa Barbara, CA) was used to proctor medical students during an anatomy class cadaver dissection. The ability of the remote surgeon to effectively monitor the students' dissections and direct their activities was assessed subjectively by students and surgeon. This device was very effective at providing a controllable and interactive presence in the anatomy lab. Students felt they were interacting with a person rather than a video screen and quickly forgot that the surgeon was not in the room. The ability to move the device within the environment rather than just observe the environment from multiple fixed camera angles gave the surgeon a similar feel of true presence. A remote-controlled videoconferencing system provides a more real experience for both student and proctor. Future development of such a device could greatly facilitate progress in implementation of remote presence proctoring.